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Aging, Illness and Self-Esteem

Although people can flourish as they get older, aging is difficult and requires us to manage a number of blows regarding the ways our bodies change and let us down. Among these difficulties are alterations in physical appearance, a feeling of less control over our bodies, susceptibility to injury and illness, and an increase in physical pain.

Aging and illness requires us to manage a number of hits to self-esteem. As we get older most of us have to deal with the narcissistic injury of having bodies that don’t work as well as we would like.

Narcissism can be viewed as a negative word in psychology and psychoanalytic theories. 9See this Psych Central page for a description of excessive narcissism.) However, narcissism not only has normal and developmental underpinnings, some level of narcissistic defenses (not when narcissism is a personality disorder) are crucial to our being able to manage a number of stresses and disappointments in life. Even Freud (1917) implied that there is normal and excessive narcissism. Kohut took this many steps further, however, and questioned whether narcissism is fundamentally pathological. Among the many things he said, one of the most important is that it may not be so unusual for us to want to be loved and admired.

Our relationships with our bodies are inherently narcissistic. We expect to control our bodies and expect them to work when we want them to. We need to feel competent—athletes know this idea quite well as they require a certain kind of performance from their bodies on a regular basis. Additionally, although excessive self-sufficiency can be problematic, many people take comfort in knowing that they can do most things for themselves.

Aging and illness can change the ways we relate to our bodies. In extreme examples, illness can require extreme dependency, such as when people need help using the bathroom or getting dressed in the morning. Many older adults who do not experience this level of dependency often complain about needing reading glasses or needing to write things down so they remember them. Such minor adjustments can be hard for people who experience themselves and their bodies as not needing assistance.

In order to age well, we have to come to terms with the fact that our bodies stop serving us as well as they used to. For many aging is a blow, but I worry that the culture of psychology and the negative understandings of narcissism make it hard for people to feel like they can have negative feelings about aging. The literature in popular culture may even make this worse. Much of what we see in the popular press has to do with a blatant denial of aging. Ideas that we can stop the aging process are all over the Internet these days. And if you can’t change internal aging, just change it externally by doing everything you can to look younger. It is as if changing the outside (our appearance) will alter the inside (our physical biology).

This strikes me as more than a bit sad. Aging is a reality and it causes us to feel bad. Even people who are lucky enough to age with minimal limitations still suffer some degree of loss. For those who are subject to illness, they have even more grieving to contend with. Part of dealing with the sadness associated with growing older is to realize that aging and illness are narcissistic blows. Our self-esteem can suffer as we age.

It hurts to grow older—emotionally and sometimes physically. Managing self-esteem as we age is more about accepting limitations and not pretending that they do not exist.

Aging, Illness and Self-Esteem

Tamara McClintock Greenberg, Psy.D.

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APA Reference
Greenberg, T. (2011). Aging, Illness and Self-Esteem. Psych Central. Retrieved on January 20, 2020, from


Last updated: 27 Sep 2011
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